Thursday, March 23, 2017

Use of Narrative Medicine (1)

Charon writes that she first used the term ‘narrative medicine’ in 2000. She writes “to refer to clinical practice fortified by narrative competence – the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness. Simply, it is medicine practised by someone who knows what to do with stories” [Charon, 2007]. In science and medicine, there has been a more recent interest and attention paid to qualitative research including the narrative element, participant-observer studies, ethnographical interviews and focus groups [Charon, 2012]. Divinsky [2007] suggests that “in scientific terms – if we make sense of the world by recognizing patterns and thinking in categories – being able to narrate a coherent story is a healing experience” [Divinsky, 2007].
Indeed, there is something fundamentally human about telling and sharing stories, in order to gain insight and meaning into another person’s world. It is what we do every day. In narrative medicine we are suggesting that the medical professional tries to honor and understand the stories of those they are caring for [Nowaczyk, 2012]. This can also benefit the medical professional in that they have the ability to also share the story so that they can come to an agreed meaning with the patient [Charon, 2001; 2007; Nowaczyk, 2012]. This, in turn, leads to a deepening understanding and empathy by the medical professional of the patient’s plight, and improves patient-physician relationships [Charon, 2001]. Another advantage of narrative medicine for medical professionals is that it can help prevent burnout and retain empathy that may become somewhat diminished during their career [Divinsky, 2007].
Firstly it is essential that they gain the trust of the patient. This is fundamental to the beginning of the relationship, as is the crucial need to listen to the patient’s story. The need for narrative medicine in this patient cohort is absolutely vital. Time is paramount, which is a potential difficulty which somehow must be negated when one sees a patient with a chronic and long-term condition. Although this maybe a complication in terms of health economics, in the long-term it will prove to be far more beneficial. Of course in private practice this is much easier than with, for example, the constraints of the (UK) National Health Service.

Here, I talk about narrative medicine:

Charon R. 2001. Narrative medicine – a model for empathy, reflection, profession and trust. JAMA 286: 1897-1902.
Charon R. 2007. What to do with stories – the sciences of narrative medicine. Can Fam Physician 53:1265-1267.
Charon R. 2012. At the membranes of care: stories in narrative medicine. Acad Medicine 87: 342-347.
Divinsky M. 2007. Stories for life. Canadian Family Physician. 53: 203-205.

Knight I. 2011. A Guide to living with hypermobility syndrome – bending without breaking. London: Singing Dragon Press.
Knight I. 2013. Managing Ehlers-Danlos type III hypermobility syndrome. London: Singing Dragon Press.

Nowaczyk M. 2012. Narrative medicine in clinical genetics practice. Am J Med Genet A 158: 1941-1947.

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